Figure 3

Repeat transesophageal echocardiography (TEE) study. A 5-chamber view. Tumor formation in both left and right sided cardiac structures, mitral and tricuspid valves are affected. Of note, both, the right atrium and the right ventricle are significantly obstructed. B Mid-esophageal 4-chamber view confirming extensive tumor formation and showing significant involvement of the mitral valve leaflets. Both, the right atrium and the right ventricle are severely obstructed. C Mid esophageal long axis confirming mitral valve involvement. D 4-chamber view, with cut apex. Tumor formation on mitral valve, however mitral valve apparatus does not appear to be diffusely infiltrated or misconfigured.